10. Ensuring Quality in PACS Flashcards

1
Q

Radiology has both _______ quality

A

people-centered & product-centered

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2
Q

Has always been a part of health care, whether as a

service or product

A

Quality

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3
Q

The ultimate focus in health care is to ___________ so that patients will want to return

A

improve patient

care & provide a high-quality service

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4
Q

JCAHO

A

Joint Commission on the Accreditation

of Healthcare Organizations

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5
Q

Voluntary but necessary to obtain Medicaid
Certification, hold certain licenses, obtain
reimbursements from insurance companies, &
receive malpractice insurance

A

Joint Commission on the Accreditation

of Healthcare Organizations (JCAHO)

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6
Q

Rather than quality, TJC (The Joint Commission) currently uses terms

A

Continuous Quality Improvement or

Total Quality Management

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7
Q

A plan for the systematic observation & assessment of the different aspects of a project, service, or facility to make certain that standards of quality are being met

A

Quality Assurance

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8
Q

QA (Quality Assurance) activities are focused around

A

people & service

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9
Q

Most QA activities will produce _______ that can be analyzed

A

quantitative data

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10
Q

These data can be used to
monitor the processes &
determine whether the process is working as it should & whether the standard of quality
has been met

A

quantitative data (Quality Assurance)

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11
Q

Defined as a comprehensive set of activities
designed to monitor & maintain systems
that produce a product

A

Quality Control

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12
Q

QC measures are instituted to ensure

that radiologic procedures are:

A

✓ performed safely
✓ appropriate for the patient
✓ performed efficiently
✓ produce a high-quality image

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13
Q

QC measures are required by law to maintain the _____ for the room or department

A

license

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14
Q

The data from the various activities are kept by a

________ within the department

A

designated individual

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15
Q

Most QC activities are part of a _____, & the data

are used to improve the quality of the processes& the department

A

QA program

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16
Q

3 MAJOR CATEGORIES OF QC TESTS

A
  1. Acceptance Testing
  2. Routine Maintenance
  3. Error Maintenance
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17
Q

Performed before newly installed
or majorly repaired equipment can
be accepted by the department

A

Acceptance Testing

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18
Q

Testing may be performed by a designated technologist, a

radiation physicist, or by service personnel employed by the hospital

A

Acceptance Testing

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19
Q

Used to determine whether the equipment is performing within the vendors specifications & as
promised

A

Acceptance Testing

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20
Q

Performed to ensure that the equipment is performing as expected

A

Routine Maintenance

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21
Q

Can catch problems before
they become radiographically
apparent

A

Routine Maintenance

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22
Q

Testing may be performed by a designated technologist, a
radiation physicist, or by
service personnel employed by the vendor

A

Routine Maintenance

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23
Q

When errors occur in equipment performance, corrective action must occur
These corrections will generally be made by service personnel employed by the vendor.

A

Error Testing

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24
Q

Errors will be detected by poor equipment performance or poor quality outcomes

A

Error Testing

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25
Q

CQI

A

Continuous Quality Improvement

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26
Q

Focus more on the process rather than on the people

or the service

A

Continuous Quality Improvement (CQI)

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27
Q

Belief is: If the process is good, health care workers

will follow it, & service will be good

A

Continuous Quality Improvement (CQI)

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28
Q

The ____ does not replace QA/QC programs

A

Continuous Quality Improvement (CQI)

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29
Q

The QA/QC programs focus on ______ a certain level of quality, not necessarily improving to
a higher quality

A

maintaining

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30
Q
focuses on improving
the process or system 
within which the 
people function as 
team members rather 
than focusing on an 
individual’s work
A

Continuous Quality Improvement (CQI)

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31
Q

All levels of people within the organization must be involved in
the process of improvement

A

CONCEPT OF CQI (Continuous Quality Improvement)

32
Q

It is important that everyone
participate because if one spoke is not involved, the wheel will fall off, & the quality cart
cannot move forward

A

CONCEPT OF CQI (Continuous Quality Improvement)

33
Q
Systemic observation & 
assessment of the different 
aspects of a project, service 
or facility to make certain 
that standards of quality are 
being met
A

Quality Assurance

34
Q
Comprehensive set of 
activities designed to 
monitor & maintain systems 
that produce
a product
A

Quality Control

35
Q

When beginning a QC program, care must be taken to ______ all surrounding variables so that each quality measure can be repeated without harm to the process

A

document

36
Q

very important in any QC activity & all paperwork must be kept up to date to make a valid performance measure

A

Documentation

37
Q

is the most difficult part of the process & the easiest part to not complete

A

Documentation

38
Q

Without the ________ to back up the findings,
it will be difficult to prove the need for repair or
update of a system

A

Documentation

39
Q

QC ACTIVITIES
to be monitored in a PACS environment
includes:

A
  1. Display quality for both monitor & film
  2. Processing speed
  3. Network transfer speed
  4. Data integrity (Data from archive)
40
Q

Many vendors have suggestions for what

should be monitored for their systems

A

QC ACTIVITIES

41
Q

It is very important that vendor’s list &
timetable for these various activities be
followed

A

QC ACTIVITIES

42
Q

If any QC activity results in an ________
result, the appropriate personnel should be
notified & actions should be taken to remedy
the situation

A

unacceptable

43
Q

Any facility using a digital image data management system must
have documented policies & procedures for monitoring &
evaluating the effective management, safety & proper performance
of acquisition, digitization, compression, transmission, display,
archiving & retrieval functions of the system. The QC program
should be designed to maximize the quality & accessibility of
diagnostic information

A

ACR Technical Standard for Digital Image

Data Management

44
Q

Also suggests that all the quality tests be
carried out with a Society of Motion Pictures & Television Engineers (SMPTE) test pattern to ensure continuity of measurements

A

ACR (American College of Radiology)

45
Q

SMPTE

A

Society of Motion Pictures & Television Engineers

46
Q

AAPM

A

American Association of Physicists in Medicine

47
Q

TG18

A

Task Group 18

48
Q

A test pattern developed by the ________ is also becoming more widely accepted for
use in these QC tests

A

American Association of Physicists in Medicine (AAPM) Task Group 18 (TG18)

49
Q

suggests that the testing be
performed on acceptance & annually by a trained physicist & the daily &
monthly/quarterly tests can be performed by a trained QC technologist or a physicist

A

American Association of Physicists in Medicine (AAPM)

50
Q

If any of the following tests fails or produces out-of-range readings, ______ should be done

A

corrective action & continued monitoring

51
Q

The ______ should follow the radiology department’s policy on equipment
maintenance procedures

A

technologist

52
Q

It may be necessary to contact a _______ to follow up on the findings

A

radiation physicist

53
Q

is often the weakest link in the digital imaging chain

A

Monitor

54
Q

has a direct effect on the quality of the
image that is presented to the radiologist for reading
or to the referring physician for review

A

Monitor

55
Q

It is not ______ to provide the highest-quality monitor for all viewing
situations

A

cost-effective

56
Q

Radiologist Workstation Monitor:

A

2K-3K monitors for digital projection images
1K-2K cross-sectional images
Up to 4K for mammography

57
Q

QC recommendations for display monitors from AAPM Document entitled:

A

Assessment for Display Performance for Medical Imaging Systems

58
Q

Testing should be completed both by _____ & by _______ on a daily & monthly/quarterly
basis on all monitors used to view images

A

physicists,

technologists/users

59
Q

Daily Monitor QC

A
  1. Turn on the monitor, allow it ample time to warm up.
  2. Make sure that the monitor is dust free on the
    viewing surface & near the airflow areas.
  3. Retrieve a QC monitor test pattern (SMPTE or AAPM
    TG18-QC)
  4. General image quality & appearance
  5. Geometric distortion
  6. Luminance, reflection, noise & glare (luminance
    meter or photometer)
  7. Resolution
60
Q

A device used to
measure luminescence
of areas on the
monitor

A

Photometer

61
Q

Evaluate the results in
comparison to previous
measurements

A

Photometer

62
Q

Printer Image Quality

A
  • Wet Laser Imager

- Dry Laser Imager

63
Q

Always a concern in the radiology department, whether it is the ______ at
which patients are brought back for their X-rays or the ______ at which the radiologists gets a final report signed

A

speed,

speed

64
Q

Speed

A
  • Workstation Processing Speed

- Image Transfer Speed

65
Q

Data Quality Control

A
  1. Data Integrity

2. Compression Recall

66
Q

Technologist should check on a daily basis to make sure all images sent to the PACS arrived on the PACS
• Daily/Weekly/Monthly

A

Data Integrity

67
Q

Used to reduce the size of the image files to
increase the speed of the network transfer of the
images

A

Compression Recall

68
Q

established the compression protocol, and they determine the level of compression that will be acceptable for the institution

A

Radiologist/Radiation physicists

69
Q

PACS Continuous Quality Improvement

A
  1. Recognition of Nondiagnostic Images
  2. System Up-Time
  3. System Training
70
Q

Documentation of nondiagnostic image being forwarded to the PACS

A

Recognition of Nondiagnostic Images

71
Q

Poor-quality Image Causes:

A
  1. Equipment Malfunction

2. Operator Error

72
Q

QC test & appropriate service protocol

should be used

A

Equipment Malfunction

73
Q

Additional training or counselling

A

Operator Error

74
Q

Monitor how often the system is down

A

System Up-Time

75
Q

A log should be kept to note any time the system
is down, the reason, how long, what had to be
done to fix the problem, & who fixed the
problem

A

System Up-Time

76
Q

An important activity that must never stop

A

System Training

77
Q

The vendor applications training is supposed to train several _______ (people who are trained on all aspects of the system & are prepared to train others)

A

super users